an enema. At the time the midwives and nuns were switching from old-style and easily smashed glass to rubber. Back then every woman in labour was given an enema but they are no longer deemed necessary during childbirth. — II. Dettol was a well-known antiseptic. Today its function has largely been replaced by plain water after fears that strong antiseptics kill good bacteria as well as bad. — III. There was a nursery thermometer for testing bath water – now mostly usurped by an elbow or a wrist – as well as one to register body temperature. — IV. The urine in a test tube held by clamps was warmed to see if there was any evidence of protein. If the heated urine produced a frothy substance resembling cooked egg white then it indicated a possible infection or even the threat of pre-eclampsia, a condition that can be fatal to mums and babies. Nowadays strips are used to carry out the same test. A spirit lamp – a bottle with a wick running through it – was lit for urine testing, which explains why midwives carried a box of matches with them.
(© We Are Laura)
FIGURE 2 – CONTENTS OF A MIDWIFE’S MEDICAL BAG I. Carbolic soap helped the shaving process, and was also used for handwashing. — II. Tweezers were used to remove dirty dressings, which were duly dropped into an enamel bowl. — III. Enamel bowls were carried to hold solutions or waste items. — IV. The horn-shaped Pinard, a foetal heart monitor, has been standard equipment for decades. — V. A vicious-looking stainless steel razor was used to prepare women for delivery. — VI. Scissors used to cut the umbilical cord are shaped like a parrot’s beak. — VII. Midwives carried a sphygmomanometer or blood pressure measuring device with a fabric cuff and the dial encased in leather. — VIII. This hypochlorite solution was used as a steriliser. — IX. This ergometrine oxytocic was injected to stop bleeding after childbirth by encouraging the uterus to contract. — X. Syringes were used to administer the ergometrine. — XI. Gauze was used to tie off the umbilical cord. It was replaced first by rubber bands and then by plastic clips. — XII. Midwives carried a tube of Lanolin for women preparing to breastfeed, to prevent sore nipples. — XIII. A stethoscope – invented in France at the beginning of the 19th century.
(© We Are Laura)
The oils, gels and creams are used to match the actual babies used in close-ups. Disconcertingly, the prosthetic babies have interchangeable male and female genitalia, though these are never seen. Robust enough for repeated, long-term use, the handmade dolls cost £5,000 apiece and are treated with the utmost care.
Terri’s expertise provides an essential link between past and present on the show. Having qualified in 1982, she worked alongside many midwives who would have been Jenny Lee’s contemporaries. From them, she learned about the methods in use decades previously. Perhaps surprisingly, relatively little has altered.
‘Babies still come out in exactly the same way,’ smiles Terri, mulling over the small but distinct changes in practice that have occurred down the years. ‘For example, in the fifties, midwives always wore masks. It isn’t that long ago we stopped wearing them, but we don’t use them in the show because masks don’t make for good television!’ She adds, ‘Although we probably have more disposable items now, much of the equipment is largely the same.’
Terri herself still uses the same wooden Pinard – a horn-shaped foetal heart monitor – she bought when she first qualified as a midwife thirty years ago.
Some aspects of childbirth have changed beyond all recognition. As Terri says, ‘Women in the fifties expected to give birth at home, with only very basic pain relief, and as a result they coped.’
In fact, in Series One of Call the Midwife, the women were offered no help with pain at all. I had queried this with Jennifer Worth, after reading the original books. She replied that it had been impossible for the midwives to transport cylinders of gas-and-air on their bicycles. Even the ‘portable’ units were packed into heavy cases, and the only space on the bike was taken by the midwife’s bag.
Further research revealed that in the fifties a furore was brewing regarding pain relief in labour – almost one hundred years after it was introduced. The numbing qualities of ether and chloroform (chemicals that had to be inhaled) were discovered in the middle of the 19th century. They were swiftly pressed into use for all types of surgery, and it wasn’t long before their potential for use in childbirth was spotted.
The first woman anaesthetised during labour in the United States was Fanny Longfellow, the wife of poet and abolitionist Henry, in 1847. She later called ether ‘the greatest blessing of our age’. Meanwhile, in England, the anaesthetic power of chloroform found an illustrious fan. Queen Victoria enjoyed a happy marriage to Prince Albert, but it came at a high price – one pregnancy after another. Her labours were torture to her, and indeed she suffered so greatly that when her eldest child, the Crown Princess of Prussia, wrote to say she was expecting her own first baby, the Queen wrote back offering not congratulations but the tart comment, ‘This is HORRID news.’
The Queen’s doctors debated the value of pain relief at length before deciding to use it for her eighth delivery. Her Majesty gave birth to Prince Leopold George Duncan Albert on 7 April 1853, after inhaling chloroform from a handkerchief for 52 minutes. She described the relief this gave her as ‘delightful beyond measure’, and allowed her use of anaesthesia to be made public. Thereafter, this particular method was known as ‘Chloroform à La Reine’.
By the fifties ether and chloroform had been replaced by Trilene and gas-and-air, which was inhaled during contractions through special apparatus. Trilene, which was blue, smelled like dry-cleaning fluid. However, the kit it required was relatively light, and the assumption was that bicycle-riding midwives could transport it easily.
At the end of 1955, 259 Trilene sets were in use in the UK, and by the end of 1956 this had risen to roughly 900 sets. In 1957, an estimated 1,259 sets were being pedalled around the country by district midwives. Unfortunately, that still only represented one set of equipment for every six midwives. This caused such anger that questions were asked in Parliament – the inhalers were simply not being manufactured in sufficient numbers.
Gas-and-air, which both mothers and midwives preferred, remained too cumbersome for transportation by bike. In Parliament in 1959, the Minister of Health was quizzed by the MP representing Stoke-on-Trent. When, he demanded, was the Government going to provide midwives with motor vehicles so that they could transport gas-and-air to their patients? The Minister for Health sidestepped this rather nimbly, saying it was a ‘question for the local authorities’.
Pain relief was, of course, available in hospitals and in the small GP-led units on offer in certain areas. Very slowly, the tide began to turn against home births. In the minds of many women, a hospital birth meant a safe birth. For countless generations, being ‘brought to bed’ had been such a risky business that the church offered a special service called the Thanksgiving For Women After Childbirth in which mothers could kneel at the altar and give thanks for their survival.
Even in the fifties, as in the present day, there were some complications that could not be overcome. The first series of Call the Midwife includes one of the saddest stories from the books, that of the young and beautiful young Margaret Jones, recently married to a man rather older than herself. At the happiest point of their life together, she collapses with eclampsia, an acute complication of pregnancy. Despite the emergency delivery of her stillborn premature daughter – the only cure for the condition – Margaret dies, leaving her husband bereft. Margaret’s
